One test can save two lives

Dr Ajay Phadke
Wednesday, 14 November 2018

All about Preeclampsia, a pregnancy complication, which if undetected, can lead to life-threatening conditions

Your body is a goldmine of information, if you are vigilant. One of the biggest factors leading to complications in pregnancies is that nobody is looking for them. A common, but largely ignored condition is called Preeclampsia, a dangerous pregnancy complication. 

DIAGNOSING PREECLAMPSIA
Preeclampsia is usually diagnosed after the 20thweek of gestation. 

Along with high blood pressure, it is caused by one or more of these conditions in the body (after 20thweek of gestation) like high levels of protein in urine, low platelet count, impaired liver function, kidney problem, recent onset of headaches, etc.

The irony is that preeclampsia is so common, yet goes unidentified and untreated or misdiagnosed. Therefore all moms-to-be, irrespective of showing symptoms, must, at the beginning of pregnancy, get screened for their risk of developing pre-eclampsia later on in pregnancy. 

Most women diagnosed with preeclampsia don’t even know that they could have been pre-conditioned from an early stage. According to the National Health Portal of India, preeclampsia is reported to be present in 8-10 per cent of pregnant Indian women. 

EFFECTS
Pre-eclampsia is a leading cause of maternal morbidity and mortality. If undiagnosed, it can lead to serious, life-threatening conditions like Eclampsia and HELLP Syndrome, which puts not just the mother, but also the baby at risk. 

The condition has many other serious implications on maternal health like preterm birth (before 32nd week of pregnancy), antepartum hemorrhage, postpartum hemorrhage, acute renal failure and stillbirths in rare cases. Therefore, an early detection of preeclampsia will reduce adverse outcome in both mother and child.

WHO IS AT RISK OF PREECLAMPSIA?
Women with chronic hypertension, kidney diseases, Type 1 or Type 2 diabetes and/or family history of preeclampsia are at risk. Other well-established risk factors include first pregnancy, pregnancy at 40 years (or above), pregnancy interval of more than 10 years or twin pregnancy.

The condition mostly reveals itself after 20thweek of pregnancy, but has chances of being triggered earlier as well. The only treatment to preeclampsia is preterm delivery, which can be a terrifying reality that no expecting mother would want to face. 

The bottom line is — it is prudent to get the test done.

WHAT IS THE TEST?
Preeclampsia Screen done in the first trimester of pregnancy (11-13.6 weeks of gestation) uses Serum Biomarkers (PAPP-A, Free beta HCG and PLGF) Biophysical markers (MAP- Mean Arterial Pressure & UAPI - Uterine artery Pulsatility index) and Maternal History for Risk Stratification of developing Preeclampsia later in pregnancy.

TREATMENT
A recent meta-analysis has shown that for women with high risk for preeclampsia, low dose aspirin (<150mg/day), if started before week 16 of gestation, can cause a significant reduction in preeclampsia and IUGR (intra uterine growth restriction).

There is a dire need to drive awareness not just in expecting mothers, but also their family, caregivers and doctors. When patients complain of high blood pressure, or headaches, doctors usually advise a stress-test. One simple additional test early in pregnancy could mitigate a world of problems later on.

(The author is the Centre Head of SRL Dr Avinash Phadke Path Labs, Mumbai)

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